Thursday, December 05, 2013

On Thursday, the Associated Press reported that under the health reform law, most of the plans offered to congressional staff now include abortion coverage. “Lawmakers and their staffs now appear to be the only federal employees with access to abortion coverage through their government-supported health insurance plans,” the AP notes.

Predictably, the news is making the rounds on right-wingoutlets, sparking controversy among abortion opponents who say it proves Obamacare is allowing federal funding to finance this type of reproductive care. “This is just another example of how Obamacare expands taxpayer funding of abortion,” the president of the Susan B. Anthony List said in astatement.

In fact, the AP’s story is misleading. Although this issue has surfaced several times over the last few months, it’s an entirely manufactured controversy — largely stoked by Rep. Chris Smith (R-NJ), whose allegations form the basis of the AP’s new coverage, and furthered by the conservative media. Here’s what you need to know about how abortion coverage actually factors into Obamacare:

Taxpayer dollars are still prohibited from funding abortion, and Obamacare doesn’t change that.

Under the Hyde Amendment, a budget rider that’s been in place for nearly 40 years, federal funding is prohibited from financing abortion care. No taxpayer dollars are allowed to cover abortion, and the health reform law doesn’t do anything to change that. Under Obamacare, the insurers offering abortion coverage on the new state-wide marketplaces are required to separate out federal money to ensure it doesn’t go toward that procedure. And the health law also stipulates that at least one plan on each marketplace must exclude abortion coverage altogether, in case people are fundamentally opposed to having a plan that covers it.

This issue was created not by Obamacare, but by Republicans.

Ironically, this entire “controversy” stems from a Republican-sponsored amendment to Obamacare that has complicated the way that lawmakers and their staff may access health insurance. Sen. Chuck Grassley (R-IA) offered an amendment to the law requiring federal employees to drop the health coverage they currently get under the Federal Health Benefits Program (FEHB) and enroll in Obamacare’s insurance marketplaces instead — even though the marketplaces were never intended for people who can already access insurance through their job. The policy made it into the final version of the law, and that’s why lawmakers and their staff are now shopping for coverage in DC’s health insurance exchange. As required by law, DC’s exchange does offer several plans that exclude abortion coverage, but the majority of the plans include it. That’s the source of the current outrage.

If congressional lawmakers and staff want abortion coverage, they’ll still have to pay for it out of their own pocket.

Since the exchanges aren’t actually designed for people who could otherwise receive a generous employer contribution towards their insurance, the Obama administration was forced to figure out how to make Grassley’s amendment work in practice. In August, the Office of Personnel Management (OPM) decided that lawmakers and their staff will be able to use their employer contributions to help them buy exchange plans. Conservatives pointed out that could allow those federal employees to put government dollars toward buying a plan that includes abortion coverage — which contradicts another budget rider that prohibits federal employees from having any abortion coverage whatsoever. So, at the end of September, OPM issued another rule specifically addressing that issue.

“OPM can and will take appropriate administrative steps to ensure that the cost of any such coverage purchased by a Member of Congress or a congressional staffer from a designed SHOP is accounted for and paid by the individual rather than from a government contribution, consistent with the general prohibition on Federal funds being used for this purpose,” the new rule stipulated.

In other words, even if a lawmaker ends up buying one of the 103 plans on DC’s exchange that includes abortion coverage, OPM will figure out how to divide the funds so the employee is required to cover that cost on their own. These federal workers are not, in fact, gaining access to government-funded abortion services.

Obamacare doesn’t expand abortion coverage. The health law actually limits it even further.

Obviously, as OPM’s new rules demonstrate, the government continues to trip over itself to ensure that federal dollars are completely separated from abortion care. Although conservatives have suggested that the government is “scheming” to finally sneak in abortion coverage for some federal employees, that accusation just doesn’t make sense in light of the complicated workarounds to keep segregating abortion from the rest of insurance coverage.

And more broadly, it’s highly misleading to suggest that the health reform law represents some kind of massive expansion of abortion coverage. In fact, the direct opposite is true. Obamacare has actually provided an avenue for state legislatures to restrict access to abortion even further. Since the health law allows each state to determine how to handle abortion coverage in the new exchanges, more than 20 states have seized on the opportunity to outlaw abortion coverage altogether in their Obamacare exchanges. Under those state laws, women signing up for exchange plans must purchase an extra insurance rider if they want to avoid paying out-of-pocket for the full cost of an abortion, an expensethat can range from $300 to $3,000 dollars.

The ACLU filed suit against one of those states, Kansas, to combat this anti-choice attack on women’s private health insurance coverage. (That lawsuit was later dismissed.) But this is an extremely popular method of limiting access to reproductive care, and more states continue to pile on. This week, lawmakers in Michigan are considering this type of legislation.

UPDATE

This post has been updated to reflect the fact that the ACLU has since dropped its lawsuit against Kansas.